2024 New Law Alert: California
Published on:
As it is every year, numerous pieces of legislation impacting physicians were signed into law in California in 2023. The following new health laws are particularly relevant to physician practices and medical professional liability.
This alert is based on information obtained from the California Medical Association. All laws are effective January 1, 2024, unless otherwise noted.
Allied Health Professionals:
AB 1070 – Supervision of Physician Assistants: Exceptions
Permits a physician and surgeon to supervise up to 8 physician assistants at one time if all the physician assistants are focused solely on performing in-home health evaluations to gather patient information and perform annual wellness visits or health evaluations that do not involve direct patient treatment or prescribing medication. (Amends Business and Professions Code §3516)
*MIEC note: This law allows an exception of the maximum number of physician assistants (up to 8) for each supervising physician in home health settings or other settings in which no medical treatment or prescribing occurs. In other settings, physicians may supervise up to 4 physician assistants at one time.
Behavioral Health:
SB 43 – Behavioral Health
Expands the definition of “gravely disabled” for purposes of either placing a person on an involuntary psychiatric hold or conservatorship. The new definition of “gravely disabled” includes individuals with either a severe substance use disorder, or a co-occurring mental health disorder and a severe substance use disorder, and individuals who, due to a mental health disorder or one of the two above conditions, are unable to provide for their personal safety or necessary medical care.
(Amends Health and Safety Code §1799.111; Amends Welfare and Institutions Code §§5008, 5350, 5354, 5402; Adds Welfare and Institutions §5122)
Confidential Information:
AB 352 – Health Information
Requires specified businesses that electronically store or maintain medical information on the provision of sensitive services on behalf of a provider of health care, health care service plan, pharmaceutical company, contractor, or employer to develop capabilities, policies, and procedures, on or before July 1, 2024, to enable certain security features, including limiting user access privileges and segregating medical information related to gender-affirming care, abortion and abortion-related services, and contraception, as specified. Prohibits a provider of health care, health care service plan, contractor, or employer from cooperating with any inquiry or investigation by, or from providing medical information to, an individual, agency, or department from another state or, to the extent permitted by federal law, to a federal law enforcement agency that would identify an individual or that is related to an individual seeking or obtaining an abortion or abortion-related services that are lawful under the laws of this state, unless the request for medical information is authorized in accordance with specified existing provisions of law. Exempts a provider of health care from liability for damages or from civil or enforcement actions relating to cooperating with, or providing medical information to, another state or a federal law enforcement agency before January 31, 2026, if the provider of health care is working diligently and in good faith to comply with the prohibition.
(Adds Civil Code §56.110; Amends Civil Code §56.101 and §56.108; Amends Health and Safety Code §130290)
*MIEC note: This law places special confidentiality protections on protected health information (PHI) that addresses gender-affirming care, abortion and abortion-related services, or contraception. Importantly, the law also requires healthcare providers to develop specific measures to protect this information, including separating it and placing limitations on access, by 7/1/24.
AB 1697 – Uniform Electronic Transactions Act
Permits use of electronic signatures to authorize disclosure of medical information by a provider of health care, health care service plan, pharmaceutical company, or contractor. Permits electronic signatures for the disclosure of genetic test results contained in an applicant’s or enrollee’s medical records, by a health care service plan. Permits electronic signatures for an employer to disclose medical information and genetic test results. for electronic signatures to be valid, these authorizations must expire on the occurrence of a specified date or event.
(Amends Civil Code §§56.05, 56.11, 56.17, 56.21, and 1633.3)
*MIEC note: This law allows medical practices to accept electronic patient signatures on authorizations to disclose protected health information, including genetic testing, rather than requiring a physical signature. As always, valid authorizations must include a specified time period or expiration date.
Consent:
AB 665 – Minors: Consent to Mental Health Services
Removes the requirement that a minor seeking to consent to mental health treatment or counseling on an outpatient basis, or to residential shelter services, must present a danger of serious physical or mental harm to themselves or to others or be the alleged victim of incest or child abuse.
(Amends, repeals, and adds Family Code §6924)
*MIEC note: This law expands the ability of a minor to independently consent to mental health treatment by removing the requirement that the patient be at serious risk of harm and/or be a suspected victim of abuse.
AB 816 – Minors: Consent to Medical Care
Authorizes a minor who is 16 years of age or older to consent to replacement narcotic abuse treatment that uses buprenorphine at a physician’s office, clinic, or health facility, by a licensed physician and surgeon or other health care provider, as specified, whether the minor also has the consent of their parent or guardian. Authorizes a minor 16 years of age or older to consent to any other medications for opioid use disorder from a licensed narcotic treatment program as replacement narcotic therapy without the consent of the minor’s parent or guardian only if, and to the extent, expressly permitted by federal law.
(Amend Family Code §6929; Add Family Code §6929.1)
Drug Prescribing and Dispensing:
AB 1021 – Controlled Substances: Rescheduling
States that if any Schedule I controlled substance is federally rescheduled or exempted from the Controlled Substances Act, it will automatically become lawful for health professionals to prescribe, furnish, or dispense under California law.
(Adds Health and Safety Code §11150.3)
*MIEC note: This law addresses the federal rescheduling of cannabis from a Schedule I to Schedule III controlled substance by allowing physicians to prescribe cannabis to patients for a legitimate medical purpose.
AB 1731 – CURES Database: Buprenorphine
Exempts a health care practitioner from the duty to consult the CURES database when the health care practitioner prescribes, orders, administers, or furnishes buprenorphine or other controlled substances containing buprenorphine in the emergency department of a general acute care hospital.
(Amends Health and Safety Code §11165.4)
*MIEC note: This law allows for the induction of medication-assisted treatment (MAT) of opioid addiction in the ED without needing to consult CURES.
Medi-Cal:
AB 1241 – Medi-Cal: Telehealth
Requires that a provider furnishing services through video or audio telehealth to maintain and follow protocols to offer those services in-person or offer a referral to, and a facilitation of, in-person care. Specifies that the referral and facilitation arrangement would not require a provider to schedule an appointment with a different provider on behalf of a patient.
(Amends Welfare and Institutions Code §14132.725)
Professional Licensing and Discipline:
AB 1369 – Out-of-State Physicians and Surgeons: Telehealth: License Exemption
Authorizes a person licensed as a physician and surgeon in another state, as specified, to deliver health care via telehealth to an eligible patient who, among other requirements, has an immediately life-threatening disease or condition, as specified.
(Adds Business and Professions Code §2052.5)
*MIEC note: This is one exception to California’s licensure requirement for telehealth visits, which otherwise requires a full, unrestricted California medical license for all treatment delivered to patients in the state. Of note, state licensure requirements apply to a patient’s physical location at the time of treatment, not the patient’s primary state of residence.
AB 470 – Continuing Medical Education: Physicians and Surgeons
Specifies that educational activities to fulfill the continuing education requirement for physicians and surgeons may also include activities designed to improve the quality of physician-patient communication.
(Amends Business and Professional Code §2190.1)
*MIEC note: For members, MIEC offers free online CME through Med-IQ, including courses on disclosure and apology and communication strategies, that would apply towards this educational requirement.
Public Health:
AB 1166 – Liability for Opioid Antagonist Administration
Provides that a person who, in good faith and not for compensation, renders emergency treatment at the scene of an opioid overdose or suspected opioid overdose by administering an opioid antagonist, as defined, is not liable for civil damages resulting from an act or omission, except as specified. Further provides that a person who furnishes an opioid antagonist for use at the scene of an opioid overdose or suspected opioid overdose is not liable for civil damages resulting from an act or omission, except as specified.
(Adds Health and Safety Code §1799.113)
Reporting Requirements:
AB 1417 – Elder and Dependent Adult Abuse: Mandated Reporting
Requires a mandated reporter to submit a written report within 24 hours to the long-term care ombudsperson and the local law enforcement agency if the abuse that occurred in a long-term facility was allegedly caused by another resident of the facility with dementia diagnosed by a licensed physician and there was no serious bodily injury. In all other instances, a reporter must submit a verbal report immediately or as soon as practically possible, but no longer than 2 hours, and submit a written report within 24 hours to the aforementioned recipients. The time limit for reporting begins when the mandated reporter observes, obtains knowledge of, or suspects abuse or neglect.
(Amends Welfare and Institutions Code §15630)
AB 1740 – Human Trafficking: Notice: Pediatric Care Facilities
Requires facilities that provide pediatric care, as defined, to post a notice, as developed by the Department of Justice, which contains information relating to slavery and human trafficking, including information regarding specified nonprofit organizations that a person can call for services or support in the elimination of slavery and human trafficking.
(Amends Civil Code §52.6)
*MIEC note: Pediatricians, pediatric specialists, and primary care providers can find the required Department of Justice information in different languages here: Human Trafficking Model Notice.
Reproductive Issues:
AB 1707 – Health Professionals and Facilities: Adverse Actions Based on Another State’s Law
Adds further protections for reproductive health care providers by prohibiting a healing arts board or health facilities from taking adverse actions, such as, denying staff privileges to, removing from medical staff, or restricting the staff privileges, because of another state’s law restrictions on comprehensive sexual and reproductive health care. Prohibits a healing arts board under the Department of Consumer Affairs from denying an application for a license or imposing discipline upon a licensee or health care practitioner on the basis of a civil judgment, criminal conviction, or disciplinary action in another state that is based on the application of another state’s law that interferes with a person’s right to receive sensitive services, as defined, that would be lawful in California, regardless of the patient’s location. Prohibits the denial, suspension, revocation, or limitation of a clinic or health facility license based on another states’ hostile law on reproductive health law.
(Adds Business and Professions §§805.9 and 850.1; Adds Health and Safety Code §§1220.1 and 1265.11)
AB 571 – Medical Malpractice Insurance
Prohibits an insurer from refusing to issue or renew or terminating professional liability insurance for health care providers, as specified, and from imposing a surcharge or increasing the premium or deductible solely based on any prohibited bases for discrimination, including a health care provider offering or performing abortion, contraception, gender-affirming health care, or care related to those health care services that are lawful in this state but unlawful in another state. Prohibits an insurer from denying coverage for liability for damages arising from offering or performing abortion, contraception, gender-affirming health care, or care related to those health care services, if those services are within the scope of the insured’s license, the services are lawful in the state where they are offered or performed, and the policy would otherwise cover liability for damages arising from performing or rendering other professional services within the insured’s scope of license.
(Adds Insurance Code §11589.1)
SB 487 – Abortion: Provider Protections
Adds abortion providers to the existing law that declares another state’s law authorizing a civil action against a person or entity that receives or seeks, performs or induces, or aids or abets the performance of an abortion, or who attempts or intends to engage in those actions, to be contrary to the public policy of this state, and prohibits the application of that law to a controversy in state court and the enforcement or satisfaction of a civil judgment received under that law.
(Amends Health and Safety Code §123467.5; Adds Health and Safety Code §1375.61; Adds Insurance Code §10133.641; Amends Welfare and Institutions Code §14043.6 and 14123)
*MIEC note: The above reproductive laws all support California’s position as a sanctuary state for the individual right to abortion by protecting physicians from adverse licensure or medical staff actions, adverse medical malpractice insurance actions, or enforcement of civil judgments arising from the violation of another state’s laws prohibiting the performance of, or assistance with, an abortion.